阴道镜下宫颈活检准确度影响因素分析  

An Analysis of Common Factors Influencing the Accuracy of the Colposcopy Directed Punch Biopsy

作　　者：陈观娣[1] 何裕[2] 钱德英[1] 李志刚[1] 岑坚敏[1] 舒焰红[1] 

机构地区：[1]广东省人民医院广东省医学科学院,广东广州510080 [2]广东省妇幼保健院,广东广州511400

出　　处：《实用妇产科杂志》2015年第12期951-953,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨阴道镜下宫颈活检准确度的常见影响因素。方法：对2009年1月至2013年8月在广东省人民医院阴道镜门诊行宫颈电环锥切术或宫颈冷刀锥切术的1148例患者,回顾其阴道镜下宫颈活检病理或细胞学检查结果,并进行分析统计,根据锥切病理结果判断活检病理结果的准确度,分析影响活检结果准确度的因素。结果：〈40岁与≥40岁患者宫颈活检准确度分别为76.97%和88.73%,差异有统计学意义（χ2=28.34,P〈0.001）。≤2个部位活检患者的准确度为79.72%,≥3个部位活检患者的准确度为96.61%,差异有统计学意义（χ2=46.67,P〈0.001）。宫颈转化区为Ⅰ型、Ⅱ型、Ⅲ型患者活检准确度分别为89.50%、85.35%和66.51%,差异有统计学意义（χ2=63.46,P〈0.001）。结论：年龄、活检点数、转化区类型是阴道镜下宫颈活检准确度的影响因素。Objective： To analyze the common factors influencing the accuracy of the cervix biopsy under colposcope. M ethods： The clinical data of 1148 cases diagnosed as cervical intraepithelial neoplasias after the biopsy under colposcope,and conduct the loop electrosurgical excision procedure（ LEEP） or cold knife conization in Guangdong General Hospital,from January 2009 to August 2013 were retrospectively analyzed. According to the pathology of cervical cone cutting and the pathology of biopsy under colposcope,the factors influencing the accuracy of the results were analyzed. Results： For women those less than 40 years old and those 40 years old and above,the diagnostic accuracy of colposcopy-directed punch biopsy in the diagnosis of cervical intraepithelial neoplasias were 76. 97% and 88. 73%,respectively（ χ2= 28. 34,P 〈0. 001）. The diagnostic accuracy was 79. 72%and 96. 61% for thecases taking ≤2 biopsy sites and ≥3 biopsy sites respectively（ χ2= 46. 67,P 〈0. 001）. For the cases whose transformation zone were type Ⅰ,type Ⅱ,type Ⅲ,the diagnostic accuracy were 89. 50%,85. 35% and 66. 51%,respectively（ χ2= 63. 46,P〈 0. 001）. Conclusions： Age,the number of biopsy sites and cervical transformation zone type affect the accuracy of the colposcopy-directed punch biopsy.

关 键 词：阴道镜检查 宫颈活检 宫颈锥切 宫颈癌筛查 

分 类 号：R711.74[医药卫生—妇产科学]